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Proximal junctional kyphosis and failure—diagnosis, prevention, and treatment

  • Complications in Spine Surgery (E Klineberg, Section Editor)
  • Published:
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Abstract

Technical advancements have enabled the spinal deformity surgeon to correct severe spinal mal-alignment. However, proximal adjacent segment pathology (ASP) remains a significant issue. Examples include proximal junctional kyphosis (PJK) and proximal junctional failure (PJF). Agreement on the definition, classification, and pathophysiology of PJK and PJF remains incomplete, and an understanding of the risk factors, means of prevention, and treatment of this problem remains to be elucidated. In general, PJK is a relatively asymptomatic radiographic diagnosis managed with patient reassurance and monitoring. On the other hand, PJF is characterized by mechanical instability, pain, and more severe kyphosis, with potential for neurologic compromise. Patients who develop PJF more often require revision surgery than those with PJK. This chapter will review the current understanding of PJK and PJF.

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Correspondence to Robert A. Hart.

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Ngoc-Lam M. Nguyen and Christopher Y. Kong declare that they have no conflict of interest.

Robert A. Hart is a board member for CSRS and ISSLS. He reports personal fees from DePuySynthes, Globus, Medtronic, and Seaspine. Dr. Hart also reports grants from Medtronic and ISSGF, and stock from Spine Connect.

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Nguyen, NL.M., Kong, C.Y. & Hart, R.A. Proximal junctional kyphosis and failure—diagnosis, prevention, and treatment. Curr Rev Musculoskelet Med 9, 299–308 (2016). https://doi.org/10.1007/s12178-016-9353-8

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